Emergency Room Splinting Guide | Next Journey Orthopaedics

Quick Instructions for ER providers

At Next Journey Orthopaedics, we understand the urgency of stabilizing orthopedic injuries in the emergency room. This page provides concise, step-by-step instructions for correctly applying the most commonly used splints, ensuring proper immobilization before definitive orthopedic care.

Coaptation Splint - Mid shaft humerus fractures

Position - Elbow flexed at 90 degrees if patient allows it.
Material - Cut 2 to 4 inch wide orthoglass. Measure from the axilla or armpit, looping below or around the inside part of the elbow and up the lateral or outside the upper arm and ending over top of the shoulder.
Apply Padding – Cover the entire humerus with soft padding.
Apply Splint – Wrap around the humerus, ensuring immobilization.
Secure with Bandages – Avoid over-tightening near the axilla.
Assess Fit – Ensure adequate immobilization without restricting blood flow

22612 - Lumbar spine fusion, posterior/posterolateral technique, single level
22614 - Lumbar spine fusion, posterior/posterolateral technique, each additional level
22630 - Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single level
22632 - Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single interspace
22633 - Lumbar spine fusion, combined with decompression, single level
22634 - Lumbar spine fusion, combined with decompression, each additional level
22857 - Total disc arthroplasty (artificial disc), anterior approach, lumbar22859 - Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, lumbar
22862 - Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, lumbar, each additional level
22865 - Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar
22867 - Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring, lumbar63030 - Laminotomy (decompression)
63047 - Laminectomy, facetectomy and foraminotomy, single vertebral segment
63048 - Laminectomy, facetectomy and foraminotomy, each additional segment
63056 - Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment
63057 - Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), each additional segment

22612 - Lumbar spine fusion, posterior/posterolateral technique, single level
22614 - Lumbar spine fusion, posterior/posterolateral technique, each additional level
22630 - Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single level
22632 - Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace, single interspace
22633 - Lumbar spine fusion, combined with decompression, single level
22634 - Lumbar spine fusion, combined with decompression, each additional level
22857 - Total disc arthroplasty (artificial disc), anterior approach, lumbar22859 - Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, lumbar
22862 - Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, lumbar, each additional level
22865 - Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar
22867 - Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring, lumbar63030 - Laminotomy (decompression)
63047 - Laminectomy, facetectomy and foraminotomy, single vertebral segment
63048 - Laminectomy, facetectomy and foraminotomy, each additional segment
63056 - Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment
63057 - Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), each additional segment

Posterior Long Arm Splint (For Supracondylar Fractures, Elbow Dislocations, Olecranon Fractures)

Position - Dependent on injury.
Material - Cut 2-to-4-inch wide orthoglass. Measure 2 inches distal from axilla or armpit down the back of the elbow and down the forearm until the palmar crease of the hand.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap to the back of the elbow, ensuring immobilization.
Secure with Bandages – Avoid over-tightening near the axilla.
Assess Fit – Ensure adequate immobilization without restricting blood flow

Sugar Tong Splint (For Distal Radius/Ulna Fractures, Displaced Colles’ Fractures)

Position - Depends on injury but elbow is usually 90 degrees of flexion and the wrist is usually in neutral.
Material - Cut 2 to 3 inch wide orthoglass. Measure from metacarpal head dorsally (back of the knuckles) and then up the forearm loop around the elbow and then down then forearm stopping at palmar crease of hand.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap from the hand to above the elbow to the level of the biceps making.
Secure with Bandages – Avoid over-tightening near the elbow.
Assess Fit – Ensure adequate immobilization without restricting blood flow

Volar Wrist Splint (For Wrist Sprains, Carpal Fractures, Distal Radius Fractures)

Position - Depends on injury but wrist is usually in neutral.
Material - Cut 2 to 3 inch wide orthoglass. Measure from 2 inches distal from the antecubital (elbow) crease to the palmar crease of hand.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap from the hand to 1 inch below the antecubital (elbow) crease
Secure with Bandages – Avoid over-tightening near the elbow.
Assess Fit – Ensure adequate immobilization without restricting blood flow

Thumb Spica Splint (For Scaphoid Fractures, UCL Injuries, Thumb Metacarpal Fractures)

Position - Depends on injury but wrist is usually 10 to 20 degrees of extension
Material - Cut 2 to 3 inch wide orthoglass. Measure from thumb (below or distal to injury) up to the antecubital (elbow) crease for scaphoid and carpal fractures OR to the mid forearm for UCL and thumb metacarpal injuries.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap from the hand to measured level. Apply in a U shaped fashion at the thumb.
Secure with Bandages – Avoid over-tightening near the wrist.
Assess Fit – Ensure adequate immobilization without restricting blood flow

Ulnar Gutter Splint (For Boxer’s Fractures, 4th & 5th Metacarpal Fractures)

Position - Depends on injury but wrist is usually 20 to 30 degrees of extension, 4th and 5th digits in intrinsic plus (70-90 degrees of MCP joint or hand knuckles flexion and 0-10 degrees of PIP joint or finger knuckles flexion)
Material - Cut 4 to 6 inch wide orthoglass. Measure from mid forearm to just beyond the 5th fingertip.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap from the hand to measure level. Apply in a U shaped fashion at the 5th finger.
Secure with Bandages – Avoid over-tightening near the wrist.
Assess Fit – Ensure adequate immobilization without restricting blood flow

Radial Gutter Splint (For 2nd & 3rd Metacarpal Fractures, Radial-Sided Hand Injuries)

Position - Depends on injury but wrist is usually 20 to 30 degrees of extension, 2nd and 3rd digits in positions of comfort
Material - Cut 4 to 6 inch wide orthoglass. Measure from mid forearm to just beyond the 2nd fingertip. Cut the orthoglass longitudinally leaving a bridge of about 1-2 inches remaining.
Apply Padding – Cover the same distance with soft padding.
Apply Splint – Wrap from the hand to measure level. Apply in a U shaped fashion at the 2nd finger.
Secure with Bandages – Avoid over-tightening near the wrist.
Assess Fit – Ensure adequate immobilization without restricting blood flow

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Emergency Room Splinting Guide | Next Journey Orthopaedics

Quick Instructions for ER providers

Coaptation Splint - Mid shaft humerus fractures

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ORTHOPAEDICS